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G� Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00028267 Site Location: 620 CAROLYN WESTON BLVD STE AccountlD: AR0023586 <br /> Received by. EE0001788 VAN FLEET Received Date: 5/12/2008 Print Date: 5/14/2008 9:23:56AM <br /> Assigned To; EE0001420 MENDE Assigned Date: 5/14/2008 <br /> Program/Element C 160-FOOD PROGRAM <br /> Complainant. :KIM Nome Phone <br /> Address Work Phone <br /> Nature of complaint. <br /> (C)STATES THAT SHE WENT TO FACILITY AND ORDERED A NACHOS WITHOUT JALAPENOS. WHEN(C)RECEIVED NACHOS NOTICED <br /> THERE WERE JALAPENOS. (C)TOOK NACHOS BACK AND ASKED FOR NACHOS WITHOUT JALAPENOS. AN EMPLOYEE TOOK JALAPENOS <br /> OFF WITH HANDS AND W/O GLOVES_:,(C)ALSO NOTICED EMPLOYEE TOUCHING FOOD&MONEY W/O WASHING HANDS. <br /> Complaint Moder P Complaint Mode Godes A-Agency Referral B-Bd of Supervisors 1 City Council C-Counter <br /> E-Code Enforcement M-Mail 1 Correspondence O-Other EH Unit P-Phone <br /> ------------------------------------ -------- <br /> FACILITY INFORMATION OWNER INFORMATION — <br /> Facility:FA0013954 JALAPENO'S TAQUERIA Owner: OW0011041 -CERVANTES,REYES <br /> Site Location 520 CAROLYN WESTON HLVD STE A RP/DBA • ! <br /> i <br /> STOCKTON,CA 95206 RPAddress 2735 NEMAHA WAY i <br /> STOCKTON,CA 95206 <br /> Mailing Address., 520 CAROLYN WESTON BLVD STE#A Billing Address 2735 NEMAHA WAY <br /> STOCKTON,CA 95206 STOCKTON,CA 95206 <br /> Name Phone :209-942-4147 <br /> Phone :209-234-2585 Work Phone ;209-234-2585 <br /> District 001-GUTIERREZ,STEVE Location Code 01 -STOCKTON <br /> APN 16422011 t� <br /> — —Date Abated — S=f-�`� ——— Inspector. <br /> ---- ——— ----T I— — --------- --- <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> s <br /> :;. <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# A` <br /> M. <br /> 03-NAI SENT ' 16-LETTER SENT TO TENANT <br /> 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT <br /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> ItID PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE=Transferred to WELL PROGRAM FILE <br /> FERRED TO OTHER AGENCY 20-ENFORCEMENT CASE-Transferred to UIC PROGRAM FILE <br /> 08-UNABLE TO VERIFY 28-FOODBORNE ILLNESS-Unconfirmed I No Major Violations <br /> 09-FOODBORNE ILLNESS 29-FOODBORNE ILLNESS-Major Violations Identified <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 30-15 Day Letter Sent-Confirmed Complaint I <br /> ' <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 31-15 Day tetter Sent-Alleged Com 50 <br /> Thank <br /> - <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 50-LEAD HAZ EVALUATION REQUIRED(1) Youl <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 51-LEAD HAZ WORK PLAN SUBMITTED(2) 1 <br /> Complaint History <br /> Attached But Not <br /> Scanned. <br /> 5104,rpt + <br />